Pain

Pain

Pain is your body telling you that you have hurt it. This is a good thing, important when you are injured. It can also help diagnose problems with your body. Sometimes pain continues long after it's necessary. Amputees report phantom pain in the legs or arms they no longer have. There are different kinds of pain, and describing the type is useful in diagnosis: recurring, constant, steady, knife-like, radiating, sharp, dull. Medicines that dull pain are analgesics. Those that kill all feeling are anesthetics.

Recently Answered

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    ADavid Hanscom, MD, Neck & Spine Surgery, answered
    Recent research has shown that the brain can create pain that is identical to the pain of a physical injury. Research has also shown that an emotional insult is processed in exactly the same way in the brain as a physical insult. We now know that stressful life events and our emotional reactions to them may cause pain that can be severe. Treating this type of pain with pain medications, injections or surgery is usually not effective, thus leaving the patient extremely frustrated and depressed.

    Neurological research demonstrates that the brain has the capacity of neuroplasticity (the ability to create new nerve pathways in response to life events). For example, when you learn to play the piano or swing a golf club, your brain cells are developing new pathways that are connected to your body. These pathways consist of thousands of nerve cells. The more a pathway is activated or practiced, the stronger it becomes.

    What most doctors do not fully understand is that pain can be caused by this type of learned pathway. Even when there’s no tissue damage in the body, such as a tumor, a fracture, or an infection, a learned pathway can cause real, physical pain.
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    AJeffrey A. Brown, MD, Neurosurgery, answered
    When anti-convulsant (seizure) medications that used to work to treat the facial pain of trigeminal neuralgia begin to cause intolerable side effects you should obtain an MRI scan of the brain to see the trigeminal nerve. Electrical pain on one side of the face can be caused by an artery or vein pulsating against that nerve in a sensitive zone as it enters the brainstem. There are surgical options to treat this “neuropathic” facial pain that can be explained by an expert neurosurgeon experienced in the treatment of facial pain.
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    AJeffrey A. Brown, MD, Neurosurgery, answered
    Dental work or nasal surgery can spark or “kindle” a unique kind of pain that comes from the nerve to your face and not from your teeth or jaw. This “neuropathic” pain typically has electrical quality to it and does not respond to anti-inflammatory medicines or traditional pain medicines. The cause is thought to be a kind of “short circuit” of the nerve caused by an artery or vein pulsating against the nerve near the brainstem, the problem is not in your face, jaw or teeth. The pain may be alleviated by a medicine that is also used to treat seizures. It works by slowing electrical conduction in the nerve. To be sure of the cause, you may want to see a neurologist or neurosurgeon who has experience in treating facial nerve pain.
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    ANeil Martin, MD, Neurosurgery, answered on behalf of UCLA Health
    The most common type of facial pain is pain related to dental problems, such as an abscess in a tooth or a cavity. That pain is located on one side of the face in the jaw, is worse with eating and is worse with touching or manipulating a specific tooth. It's usually an aching pain, and many of us are familiar with this sort of pain. When you have that kind of pain, then a dental evaluation is obviously the first thing to do.
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    AScripps Health answered
    When muscle and joint pain arises, some parents will give their kids anti-inflammatory medications before practices or games so they don’t miss any playing time. The problem is, these medications only block the chemical process that produces inflammatory pain, so continuing the activity simply puts more stress on the already-injured tissue. By masking important symptoms, kids run the risk of experiencing more extensive injuries and more time away from the action. Ice is preferable to anti-inflammatories as a first-line treatment for pain after injury or activity.
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    The emotional component of pain is multifactorial and includes past experiences, genetic factors, general states of health, the presence of depression and other psychological diagnosis, coping mechanisms and beliefs and fears surrounding the pain diagnosis. Importantly, thoughts as well as other sensations can influence the sensory pain input to consciousness as well as the emotional coloring of the pain sensation. The term given for this modulation of pain impulses is the "gate control theory of pain." Thus thoughts (beliefs, fears, depression, anxiety, anger, helplessness, etc.), as well as peripherally-generated sensations can both dampen or amplify pain. Indeed, in many chronic pain conditions (that lack of any effective therapy for the sensory/pain component), a reduction of pain and the resulting suffering can only be affected by modulating the psychological aspects of pain. As the psychological contribution to pain varies enormously from person to person, this approach has to be individualized.
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    It is a common misconception to view the nervous system as being "hard-wired;" that is, stimulation of a nerve ending (say a needle prick) always produces the same behavioral and affective response. This concept implies that the same intensity of pain stimulus will always elicit the same degree of nerve stimulation and hence the same subjective experience of pain. It is now understood that the concept is wrong.

    Researchers have proposed that pain is a complex integration of noxious stimuli, affective traits and cognitive factors. In other words, the emotional aspects of having a chronic pain state and one's rationalization of the problem may both influence the final experience of pain. The first experimental evidence that the nervous system was not hard-wired was presented in 1965. They noted that a repetitive stimulation of a peripheral nerve, at sufficient intensity to activate C-fibers, resulted in a progressive build-up of the amplitude of the electrical response recorded in the second order dorsal horn neurons. If the system had been hard-wired, each stimulus would have elicited the same response in the second order neuron. They termed this phenomenon "wind-up." It is now appreciated that the phenomenon of wind-up is crucial to understanding the problem of chronic pain via the mechanism of "central sensitization."
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    A few unfortunate individuals have a congenital absence of pain sensation. They do not fare well due to repeated bodily insults that go unnoticed. People with an acquired deficiency in the pain sensation (e.g., diabetic neuropathy or neurosyphilis) can develop a severe destructive arthritis -- a result of repeated minor joint injuries that are overlooked.
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    ADevi Nampiaparampil, MD, Pain Medicine, answered
    How does diet affect pain?

    A healthy diet helps with weight management, which in turn helps prevent or lessen pain. In this video, Devi Nampiaparampil, MD, chief of pain management at U.S. Department of Veterans Affairs, discusses the connection between pain relief and food.


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    ARobin Miller, MD, Integrative Medicine, answered
    Is there a way to quantify pain?

    There might be a way to quantify physical pain. Watch this video with Robin Miller, MD,  as she discusses the results of a study measuring brain waives and how this information could be used to create better pain treatment.